Patient travel for bariatric surgery: does distance matter?

Background: Increasingly, patients are faced with greater travel distances to undergo bariatric surgery at high-volume centers.

Objectives: This study sought to evaluate the impact of travel distance on access to care and outcomes after bariatric surgery.

Setting: Patients who underwent Roux-en-Y gastric bypass at an academic bariatric surgery center from 1985 to 2004 were examined and stratified by patient travel distance.

Urinary Incontinence Before and After Bariatric Surgery.

Importance: Among women and men with severe obesity, evidence for improvement in urinary incontinence beyond the first year after bariatric surgery-induced weight loss is lacking.

Objectives: To examine change in urinary incontinence before and after bariatric surgery and to identify factors associated with improvement and remission among women and men in the first 3 years after bariatric surgery.

Design, Setting, And Participants: The Longitudinal Assessment of Bariatric Surgery 2 is an observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers.

Pulmonary embolism and gastrointestinal leak following bariatric surgery: when do major complications occur?

Background: Complications following bariatric surgery are uncommon but potentially life threatening.

Objectives: The aim of this study was to assess the timing of gastrointestinal leaks (GIL) and pulmonary embolism (PE) in patients undergoing bariatric surgery.

Setting: Retrospective analysis of the nationwide American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2011.

Delayed repair of obstructing ventral hernias is associated with higher mortality and morbidity.

Background: Patients presenting with ventral hernia-related obstruction are commonly managed with emergent ventral hernia repair (VHR). Selected patients with resolution of obstruction may be managed in a delayed manner. This study sought to assess the effect of delay on VHR outcomes.

Bariatric Surgery in Patients with Dialysis-Dependent Renal Failure.

Background: Laparoscopic procedures for the treatment of morbid obesity are commonly offered to patients with comorbidities previously thought to carry prohibitive operative risk. In this study, we reviewed characteristics and perioperative outcomes of patients with dialysis-dependent renal failure (DDRF) who underwent laparoscopic bariatric procedures.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2006 to 2011 was reviewed.

Synchronous Ventral Hernia Repair in Patients Undergoing Bariatric Surgery.

Background: Obesity predisposes patients to abdominal wall hernias. Patients undergoing bariatric surgery are not uncommonly found to have ventral hernias. Synchronous ventral hernia repair (S-VHR) has been reported in 2-5% of patients undergoing bariatric surgery.

Hyperinsulinemic syndrome: the metabolic syndrome is broader than you think.

Background: Type 2 diabetes mellitus (T2DM) is characterized by hyperinsulinemia. In 2011 we showed that gastric bypass (RYGB) corrects these high levels even though insulin resistance remains high, ie, the operation "dissociates" hyperinsulinemia from insulin resistance. RYGB produces reversal of T2DM along with other diseases associated with the metabolic syndrome.

Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study.

Objective: To examine changes in depressive symptoms and treatment in the first 3 years following bariatric surgery.

Methods: The longitudinal assessment of bariatric surgery-2 (LABS-2) is an observational cohort study of adults (n = 2,458) who underwent a bariatric surgical procedure at 1 of 10 US hospitals between 2006 and 2009. This study includes 2,148 participants who completed the Beck depression inventory (BDI) at baseline and ≥ one follow-up visit in years 1-3.

The effect of obesity in adolescence on adult health status.

Objective: To test the hypothesis that adolescent obesity would be associated with greater risks of adverse health in severely obese adults.

Methods: Before weight loss surgery, adult participants in the Longitudinal Assessment of Bariatric Surgery-2 underwent detailed anthropometric and comorbidity assessment. Weight status at age 18 was retrospectively determined.

Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.

Importance: Severe obesity (body mass index [BMI] ≥35) is associated with a broad range of health risks. Bariatric surgery induces weight loss and short-term health improvements, but little is known about long-term outcomes of these operations.

Objective: To report 3-year change in weight and select health parameters after common bariatric surgical procedures.

GLP-1 response to a mixed meal: what happens 10 years after Roux-en-Y gastric bypass (RYGB)?

Background: Oral meal consumption increases glucagon-like peptide 1 (GLP-1) release which maintains euglycemia by increasing insulin secretion. This effect is exaggerated during short-term follow-up of Roux-en-y gastric bypass (RYGB). We examined the durability of this effect in patient with type 2 diabetes (T2DM) >10 years after RYGB.

Pre- to postoperative changes in physical activity: report from the longitudinal assessment of bariatric surgery-2 (LABS-2).

Background: Numerous studies have reported that bariatric surgery patients report more physical activity (PA) after surgery than before; however, the quality of the PA assessment has been questionable.

Methods: The longitudinal assessment of bariatric surgery-2 is a 10-center longitudinal study of adults undergoing bariatric surgery. Of 2458 participants, 455 were given an activity monitor, which records the steps per minute, and an exercise diary before and 1 year after surgery.

Duodenal-jejunal bypass surgery does not increase skeletal muscle insulin signal transduction or glucose disposal in Goto-Kakizaki type 2 diabetic rats.

Background: Duodenal-jejunal bypass (DJB) has been shown to reverse type 2 diabetes (T2DM) in Goto-Kakizaki (GK) rats, a rodent model of non-obese T2DM. Skeletal muscle insulin resistance is a hallmark decrement in T2DM. The aim of the current work was to investigate the effects of DJB on skeletal muscle insulin signal transduction and glucose disposal.

Reproductive health of women electing bariatric surgery.

Objective: To describe the reproductive health history and characteristics of women having bariatric surgery and to determine whether this differs by age of onset of obesity.

Design: Retrospective and cross-sectional analyses of self-reported survey data.

Setting: Six sites of the Longitudinal Assessment of Bariatric Surgery-2 study.

Mechanism for improved insulin sensitivity after gastric bypass surgery.

Context: Surgical treatments of obesity have been shown to induce rapid and prolonged improvements in insulin sensitivity.

Objective: The aim of the study was to investigate the effects of gastric bypass surgery and the mechanisms that explain the improvement in insulin sensitivity.

Design: We performed a cross-sectional, nonrandomized, controlled study.

Safety and efficacy of intravascular ultrasound-guided inferior vena cava filter in super obese bariatric patients.

Background: The morbidly obese (body mass index >40 kg/m(2)) are at significant risk of postoperative venous thromboembolism (VTE). Pulmonary embolism is the leading cause of death after Roux-en-Y gastric bypass, approximating .5%.

Epidemiology of obesity in the United States.

The challenges of the epidemic are not limited to concerns about bulk and weight. The disabilities caused by obesity are physiologic and psychosocial. The increased waist to hip girth is associated with increased risk of cardiovascular disease, hyperlipidemia, hypertension, and diabetes.